supervisor : prof. dr.hekma coordinator : ph.fatmah bakhder umm al-qura university faculty of...
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Supervisor : Prof. Dr.Hekma
Coordinator : Ph.Fatmah Bakhder
Umm Al-Qura University Faculty of pharmacology
department
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HYPER LIPIDEMIA
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INEGY
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OBJECTIVES• Trade and generic names• Mechanism of action• Clinical use• Side effects• Drug interactions• Life style
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Therapeutic class :Lipid-Lowering Agents
Pharmacological class :HMG-CoA Reductase Inhibitors
INEGY
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• Trade name :
Inegy
• generic name:
Simvastatin & Ezetimibe
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Uses of Inegy:
The main effects that produce from this drug are:• lower levels of total cholesterol,
(LDL cholesterol) and triglycerides in the blood.
• Raises levels of (HDL cholesterol).
• Hypercholesterolaemia
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So. It can use if patient has:• Homozygous Familial
Hypercholesterolaemia (HoFH)
• patients not appropriately controlled with a statin alone
• patients treated with a statin and ezetimibe
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M.O.A
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• Side effectHeadache.FatigueConstipationAbdominal painIndigestionDiarrheaNausea ,vomiting.Hot flushes.Myopathy and Rhabdomyolysis. Myoglobinuria and acute renal failure .Photosensitivity, purpura, and alopecia.
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• Drug - drug interaction
Mainly for Simvastatin Warfarin AspirinNiacin Fibrate ErythromycinVerapamil
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Drug interaction classification
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
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Simvastatin ↔ Warfarin
It acts by affecting hepatic/intestinal enzyme CYP3A4 metabolism that lead to:• Reversible Rhabdomyolysis .• Acute renal failure
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Simvastatin&ezetimibe
↔ cholestyramine• cholestyramine decreases levels of ezetimibe and simvastatin by inhibition of GI absorption.
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Simvastatin ↔ NiacinEither increases toxcity of
the other by pharmacodynamic synergism that increase risk of : • (Rhabdomyolysis ) for
Both
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simvastatin ↔ fibrateE.g. Gemfibrozil.
Either increases effects of the other by pharmacodynamic synergism lead to :• Liver damaged .• Severe myopathy and
Rhabdomyolysis – renal failure secondary to
Myoglobinuria and may result in death.
• increased risk of musculoskeletal toxicity.
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simvastatin ↔ verapamilSimvastatin ↔ erythromycin
• Verapamil
• hypertension
• angina pectoris
• cardiac arrhythmia
• erythromycin
• Anti-biotic– infecti
ons
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simvastatin ↔ verapamil
Simvastatin ↔ erythromycinThey will increase the level or effect of
simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism that lead to :• myopathy and Rhabdomyolysis – renal failure secondary to
Myoglobinuria and may result in death.
• increased risk of musculoskeletal toxicity.
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simvastatin level
• Bosentan
– (pulmonary artery hypertension)• Carbamazepine
– (seizure disorders and neuropathic pain.)
• Efavirenz
– (human immunodeficiency virus (HIV) infection. )
• Rifampicin
– (tuberculosis )
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LIFE STYLE
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DONE BYAfraa 3esaAnan fataniAnmah KinsarahGhofran RawasLamiaa alsalmyLujain AndargiriMaram KafyahNazmeyah alkyyalRazan basalmanWaad alhajjaje
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REFERENCETextbooks: Anand Ramachandran, Pharmacology recall , 2nd edition, 2007.
Medical Website :SharePractice. Featured Dx: Hyperlipidemia. 04/02/2014. http://sharepractice.com/blog/featured-dx-hyperlipidemia/ (Accessed 30 Mar 2014). University of Maryland medical center. 06/04/2012. Familial combined Hyperlipidemia. May 31, 2013. http://umm.edu/Health/Medical/Ency/Articles/Familial-combined-hyperlipidemia (Accessed 30 Mar 2014).
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SIU School of Medicine. Hyperlipidemia. http://www.siumed.edu/surgery/vascular/hyperlipidemia.html (Accessed 30 Mar 2014). Medscape. When Do Triglycerides Matter? 2014. http://www.medscape.org/viewarticle/457696_7 (Accessed 30 Mar 2014). Anupama Kizhakkeveettil, Parla S. Jayagopal and Kevin Rose. June 30, 2011. Hypercholesterolemia and Ayurvedic Medicine: A Case Report. http://www.tihcij.com/Articles/Hypercholesterolemia-and-Ayurvedic-Medicine-A-Case-Report.aspx?id=0000282 (Accessed 30 Mar 2014).